Objective and importance: This is a report of four cases of huge trigeminal neuromas that presented with the principle symptom of pathological laughter (PL).
Clinical presentation: All four patients were male and were in either the third or fourth decade of life. In addition to PL, there were neurological deficits related to trigeminal nerve, brainstem, and cerebellar dysfunctions.
Intervention: All tumors were radically excised via a lateral basal temporal approach. The PL was cured immediately after surgery.
Conclusion: PL sometimes precedes other neurological manifestations and may be a useful localizing sign. The clinical and radiological features in our cases suggest that PL is a result of extra-axial compression of the pons and adjoining neural structures.